The Surprising Connection Between Bone Health and Heart Health

The suspected link between bone health and heart health is nothing new. In their attempts to uncover links between cardiovascular disease and osteoporosis, for example, researchers have looked at several areas, such as biochemical processes, genetic factors and shared risk factors. On a parallel path, other scientists are investigating how certain vitamins and minerals interact and affect the human body, including their impact on your heart.

Again and again, the synergistic relationship among vitamin D, vitamin K2, calcium and magnesium, as well as the vital role of probiotics, continues to be highlighted. Given its universal importance, let’s take a closer look at the surprising connection between the health of your bones and the health of your heart.

The women received an oral daily dose of 1010 colony‐forming units of L. reuteri 6475 or a placebo. Those receiving the probiotic were found to suffer less bone loss (based on tibia total volumetric bone mineral density) than the placebo group. The study authors stated, “[S]upplementation with L. reuteri 6475 should be further explored as a novel approach to prevent age‐associated bone loss and osteoporosis.”3

A Chinese study published in 20174 highlighted the important role healthy gut bacteria plays for women contending with postmenopausal osteoporosis (PMO). The researchers suggested bone loss with respect to PMO is closely associated with the health of your immune system and your gut. They noted:5

“Probiotics prevent bone resorption by restoring intestinal microbial diversity, enhancing the intestinal epithelial barrier and normalizing aberrant host immune responses, as well as facilitating intestinal calcium absorption and the potential production of estrogen-like metabolites … Hence, the intestinal microbiota serves as a key factor in the pathogenesis of PMO and will also serve as a new target in the treatment of PMO.”

Probiotics Also Linked to Improved Heart Health

Researchers at Johns Hopkins University school of medicine suggest your gut bacteria not only influence your immune responses, metabolism and mood, but also your heart health.6 Jennifer Pluznick, Ph.D., assistant professor of physiology at the university, has been involved in a series of animal studies7,8,9 that suggest that during the process of eating metabolized chemicals from your gut bacteria activate receptors in your blood vessels to lower your blood pressure.

As such, Pluznick underscores the value of eating both probiotic and prebiotic foods. Yogurt, she notes, is a great example of a probiotic food. Foods high in prebiotics (nondigestible food ingredients that promote the growth of your beneficial gut bacteria) include asparagus, garlic, onions and sweet potatoes. While the blood pressure changes in mice have been significant, more research is needed to determine if the same effects take place in humans. Says Pluznick:10

“We know that there’s a symbiotic type of relationship between gut bacteria and their hosts ... Certain chemicals the gut bacteria produce can alter blood pressure. We also know that when mice or rats or people have high blood pressure, the bacteria in their guts are different. Those things each reveal a piece of the puzzle. But we don’t have enough pieces to put the entire puzzle together yet.”

Research published in the European Heart Journal11 in July 2018 asserts a healthy gut microbiome may reduce the risk of arterial stiffness in women. Scientists from Kings College London, England, led by Cristina Menni, Ph.D., evaluated 617 women for arterial stiffness using carotid-femoral pulse wave velocity (PWV). They also analyzed fecal samples to determine each participant’s gut microbiome composition.

Menni and her team noted a negative correlation between PWV values and the diversity of the gut microbiome both on an overall basis as well as for seven specific types of bacteria — two of which belong to the Ruminococcaceae family. The study authors wrote, “Specific microbes, which have previously been shown to relate to lower risk of obesity, are also associated with lower risk of arterial stiffness, after adjusting for metabolic syndrome covariates.”12

About the outcomes, Pluznick said, “[T]here have been a number of studies over the past few years … that have … argued there’s definitely some sort of connection between the gut microbiota and blood pressure control in general.”13 Added Menni, “Given the possibility of modifying the gut microcomposition via diet and probiotic supplementation, this opens therapeutic avenues for reducing arterial stiffness targeting the gut microbiome.”14

Vitamin K is a fat-soluble vitamin well-known for its role in blood clotting. As you may know, there are two different kinds of vitamin K — each type providing a unique set of health benefits. Vitamin K1 is primarily responsible for blood clotting, whereas vitamin K2 works synergistically with calcium, magnesium and vitamin D to help maintain your bone, dental, heart and skin health, among other benefits.

Vitamin K2 also plays a role in supporting healthy immune function and suppressing genes that promote cancer, as well as boosting women’s health. About K2, Dr. Kate Rhéaume-Bleue, a naturopathic physician and author of “Vitamin K2 and the Calcium Paradox: How a Little-Known Vitamin Could Save Your Life,” said:15

“For the prevention of everything from wrinkles to cancer, vitamin K2 is the missing nutrient for women’s health. Most women don’t need a calcium supplement, but vitamin K2 will channel dietary calcium to the right places. And everyone is taking vitamin D, but without K2 we’re not getting all the benefits of vitamin D, and even risking harm from it.”

With respect to bone health, a small 2018 Polish study published in the journal Nutrients16 found a correlation between increased levels of vitamin K2 and lower rates of bone fractures in children. The researchers also noted the importance of maintaining beneficial levels of calcium, vitamin D and K2, particularly the menaquinone-7 (MK-7) form of K2. The study participants included 20 children aged 5 to 15 years who were hospitalized with radiologically confirmed low-energy fractures.

The fracture group was compared to a control group of 19 children aged 7 to 17 years who did not have bone-related injuries but were hospitalized for other reasons. About the outcomes, the researchers commented, “Based on our pilot study, we hypothesize that besides vitamin D, vitamin K2 plays an important role in bone health in children. This indicates potential benefits of using supplementation of vitamin D and vitamin K2 in children to prevent low-energy bone fractures.”17

Why Vitamin K2 Is Important for Your Heart Health Too

It’s important to note vitamin K2 deficiency actually produces the symptoms of vitamin D toxicity. This includes inappropriate calcification of your soft tissues that can lead to atherosclerosis, also known as hardening of the arteries.

The 2004 Rotterdam study18 was the first large clinical research known to suggest a role for vitamin K2 with respect to reducing cardiovascular events and mortality. The 4,807 adults aged 55 and older taking part in this population study that included dietary data had no history of myocardial infarction (heart attack) at baseline. They were followed for nearly a decade.

The goal of the research was to determine whether dietary intake of vitamin K1 and vitamin K2 were related to aortic calcification and coronary heart disease (CHD). Notably, the participants with higher intakes of vitamin K2 were shown to have a lower relative risk of CHD mortality, all-cause mortality and severe aortic calcification. The intake of vitamin K1 was not related to any of those outcomes. The study authors noted, “These findings suggest an adequate intake of [vitamin K2] could be important for CHD prevention.”19

A study published in 2009,20 involving more than 16,000 women, aged 49 to 70 years, who were free of cardiovascular disease at baseline and followed for eight years, also validated vitamin K2 as a means to reduce heart disease risk. In fact, the risk of CHD dropped 9 percent for every 10 micrograms (mcg) of vitamin K2 the women consumed. Again, the intake of vitamin K1 was shown to have zero effect on cardiovascular disease.

Furthermore, a 2015 study published in the Journal Thrombosis and Haemostasis21 found taking 180 mcg per day of vitamin K2 (in the MK-7 form) for three years improved arterial stiffness in postmenopausal women, especially those who had a high degree of arterial stiffness.

How Much Do You Need and the Best Sources of Vitamin K2

Now that you realize how important vitamin K2 is to your health, you may be wondering how much to take. What is the optimal dosage of vitamin K2? Some studies — including the Rotterdam study — suggest as little as 45 mcg per day is sufficient. On the other hand, some recommend much higher dosing, such as 180 to 200 mcg per day. As a general guideline, I recommend you get around 150 mcg of vitamin K2 a day.

You can obtain healthy amounts of K2 by eating 15 grams (half an ounce) of natto each day, or a small serving of fermented vegetables. If you ferment them using a starter culture infused with vitamin K2-producing bacteria, 1 ounce will give you about 200 to 250 mcgs. Vitamin K2 will also be important if you are taking an oral vitamin D3 supplement. Although optimal ratios are not yet known, you may also need more vitamin K2 to maintain a healthy ratio to vitamin D3.

Rhéaume-Bleue recommends you take 100 mcg of vitamin K2 for every 1,000 IUs of vitamin D. That said, it can be difficult to get optimal amounts of vitamin K2 from diet alone and supplementation may be necessary. In the event you do not have access to fermented foods such as cultured vegetables, coconut or water kefir, natto or sauerkraut you will need to take a supplement.

Animal products such as beef liver and milk kefir, as well as organic, pastured butter, cheese and egg yolks are other great sources of K2. If you do opt for K2 in supplement form, make sure it’s MK-7. Also remember to take it with fat — avocado, coconut oil, grass fed butter and animal products are great choices. Taking vitamin K2 with fat is important because it’s fat-soluble and will not be absorbed otherwise.

Fortunately, you have little to worry about overdosing on K2 because it appears to be nontoxic. Even people given “overdose” levels for whole years showed no adverse effects. No matter how you consume it, keep in mind taking vitamin K2 won’t make you “feel better” in any noticeable way. Its internal workings are such that you won’t likely feel a physical difference regardless of whether you come by it through food or a supplement. That said, consume it anyway and keep doing so even if you can’t tell it is having an effect.

Don’t Forget Magnesium and Be Sure to Balance It With Calcium, D and K2

It’s well-known eating a healthy diet can still leave you short when it comes to balancing important nutrients like calcium, vitamin D and vitamin K2. Particularly when you rely on supplements, you will need to pay closer attention to how nutrients influence and interact with each other so you can achieve healthy ratios. For example, your body needs magnesium to convert vitamin D into its active form so it can turn on your calcium absorption.

Vitamin D and K2 also work together to produce and activate Matrix GLA Protein (MGP), which congregates around the elastic fibers of your arterial lining, thereby guarding your arteries against calcium crystal formation. Magnesium and vitamin K2 also complement each other because magnesium helps lower blood pressure, which is an important component of heart disease. Because K2 acts synergistically with calcium, magnesium and vitamin D, it’s important to maintain balance among these four vital nutrients.

While no precise guidelines exist, magnesium helps keep calcium in your cells so they can do their job better, and most experts recommend a 1-to-1 ratio of calcium to magnesium. Daily intake of K2 was mentioned above. As for how much vitamin D you need, I strongly recommend getting your level tested twice a year — in the summer and winter — to more effectively gauge your personal dosage.

While sensible sun exposure around high noon (or 1 p.m. if you live in an area that observes daylight saving time) is the ideal way to optimize your vitamin D levels, if you opt for a supplement be sure to mind the dose. For optimal health, it’s important you take a sufficient daily dose that will enable your body to achieve the therapeutic range of 60 to 80 nanograms per milliliter. Not sure if you are getting enough of this vital nutrient? Check out my infographic titled 7 Signs You May Be Vitamin D Deficient.

While you may not think your bone and heart health are related, it’s clear you can care for these vital parts of your body in surprisingly similar ways. By ensuring you receive sufficient daily stores of calcium, magnesium, vitamin K2 and vitamin D, as well as probiotics — through the foods you eat or in supplement form — you’ll be on your way to safeguarding your bone and heart health.